Doctor, I've written to you before and want to thank you for your prompt and tactful responses. To reiterate, my husband is HIV Poz., T-cells 499, undetectable, also has been on treatment for Hep C. The second time around he had to stop a month short because of triple bypass surgery. He is doing fine, however, he saw his gastroenterologist and confirmed the Hep C is back and viral load is very high. However, he says his numbers look good right now. This is like living a nightmare. Please answer some concerns that I have. One, was the treatment he was on for almost two years any help at all to his liver, or did he suffer side effects for nothing? Also, his doctor is looking into infergen, a shot every other day or maintenance therapy with low dose pegasus. Which is the better option do you think? Also, if he does nothing, how long does it take for the progression to start doing major damage? Please answer. Thank you.

Response from Dr. McGovern

I suspect your husband got benefit from hepatitis C treatment because interferon is an anti-inflammatory in addition to being an anti-viral. Studies have shown that use of interferon in HCV patients (with or without HIV) leads to improvement in many patients who did not respond virologically. For example, there liver looks healthier despite the fact that the virus didn't budge.

Your doctor sounds terrific and is considering multiple options. Unfortunately, we have no data on which to recommend one treatment over another in HIV patients.

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